Laserfiche WebLink
]FOR CITY VALIDATION <br />R Cn d by: <br />Date: <br /> <br />MARION COIRqTY BUILDING INSPECTION <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church SINE · Room 132 <br /> Salem, OR 97301 <br /> <br /> 24 hr. Inspection Line 373-4427 <br />Offiee: Phone 588-5147 8:0~am - 4:30pm <br />FAX: $88-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PI~MITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANC~ OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Elecuical Con~ra¢ior ] Ph~o~ <br />Mailing Address <br /> <br />Contractor's License No. <br /> <br />Co~traetor's Board Rea. No, <br /> <br />Signature of Supervislug Electrician <br /> <br />[ JobNo. <br /> <br />2B. FOR OWHER INSTALLATIONS <br /> <br />Marion County does not require a plan review. <br />We will provide plan review service if you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />Issued by: <br /> <br />4. FEB SCHHDULE (Comple~o sad e. nter total h A1 below) <br /> Number of Inspections pe~ permit allowed <br />A. <br /> Re~identlul <br /> Unit <br />Servieelnehded: Items Co~t(eech) Sum I <br />tO00 ~t. fl. or l~s $S5,00 4 <br />Each additional 500 sq, fl. <br /> ~ portion ~e~of $15.00 <br />Limited EnerW/ $20.00 1 <br />Each Manufactur~l Home or Modular <br /> Dwelling S~rvice or Fe, ed~r $40.00 2 <br /> <br />B. 8ervluee or Paed~s (Does not include branch circuits, eec seatlun D) <br /> Inatallnt'~, Altnration ~ Reloeati~ <br /> 200 nmp~ or les~ $50.00 2 <br /> 201 amt~ to 400 ~ $60.00 2 <br /> 401 amt~ ~o 600 aml~ $100.00 <br /> ~1 nml~ to 1000 amps $130.00 2 <br /> Over 1000 *raps or volts $30000 2 <br /> Reconnect only $40.00 <br /> <br />C. Tempcesry 8erviee~Feed~s <br /> Installut|on, Alte~atloa, or P,,elo~atlun <br /> <br /> 201 aml~ to 400 nn~ $40.00 __% <br /> 401 amp~ to 600 amp~ $80.00 2 <br /> O~r 600 amps or 1000 volts <br /> <br />D. Brattch Cir~aits <br />a) The fee for bran0h circuits with <br />Each branch circuit $ 2.00 <br /> <br /> Each pump or irrigation ci~le <br /> Each sign or outline Ii,fluS <br /> Signal circuit(s) or a limited energy <br /> l~ne~, alte~ation or e~xtenalon <br />P. Each additional inq~eetlon <br /> Over the allowable in any of the <br /> above, per Inspection <br />O. Min~ InatnEation Labels <br /> Pack of 10 labels ~ $5.00 each <br /> (sold oM~ 1o electrical <br />H. Other <br /> <br /> Almorn Dwelling Eleclrieel Fee <br /> Dwelling Permit Label <br /> <br />Mia~lluaeous (Servk~ ~r peede~ Not l~ehded) <br /> <br />$35.00 <br />$ 2.00 <br /> <br />$40.00 2 <br />$40.00 2 <br /> <br />S40.00 2 <br /> <br />$35.00 <br /> <br />$5O.OO <br /> <br /> sq. fl. x $.068 = <br /># of l.,abels. <br /> <br />N/C <br /> <br />5. FBE8 <br /> A 1. Enter Iotal of foes from Sec. fi4 <br /> A2. Add 5% sumharge (.05 x Al) <br /> ~ubt~tal <br /> <br /> B. Enter 25% of fine A t for Plan Roview <br /> (See. 3), if required <br /> C. Investigation Fee (if required) <br /> D. Reimpecfion Pe~ ($25.00) <br /> <br /> TOTAL AMOUNT DUB <br /> Receipt No. <br /> <br />$__ <br /> <br />$__ <br />$__ <br />$__ <br /> <br />MC 15-341/96 <br /> <br /> <br />